Skip to main content
Log in

Emergent carotid artery stenting using a flow reversal system for acute atherosclerotic occlusion of the internal carotid artery

  • Case Report
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Adams HP Jr, Bendixen BH, Leira E, Chang KC, Davis PH, Woolson RF, Clarke WR, Hansen MD (1999) Antithrombotic treatment of ischemic stroke among patients with occlusion or severe stenosis of the internal carotid artery: A report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST). Neurology 53(1):122–125

    PubMed  CAS  Google Scholar 

  2. Eckstein HH, Schumacher H, Klemm K, Laubach H, Kraus T, Ringleb P, Dörfler A, Weigand M, Bardenheuer H, Allenberg JR (1999) Emergency carotid endarterectomy. Cerebrovasc Dis 9(5):270–281

    Article  PubMed  CAS  Google Scholar 

  3. Flint AC, Duckwiler GR, Budzik RF, Liebeskind DS, Smith WS, MERCI and Multi MERCI Writing Committee (2007) Mechanical thrombectomy of intracranial internal carotid occlusion: pooled results of the MERCI and Multi MERCI Part I trials. Stroke 38(4):1274–1280

    Article  PubMed  Google Scholar 

  4. Hauck EF, Natarajan SK, Ohta H, Ogilvy CS, Hopkins LN, Siddiqui AH, Levy EI (2011) Emergent Endovascular Recanalization for Cervical Internal Carotid Artery Occlusion in Patients Presenting with Acute Stroke. Neurosurgery. doi:10.1227/NEU.0b013e31821cfa52

  5. Jovin TG, Gupta R, Uchino K, Jungreis CA, Wechsler LR, Hammer MD, Tayal A, Horowitz MB (2005) Emergent stenting of extracranial internal carotid artery occlusion in acute stroke has a high revascularization rate. Stroke 36(11):2426–2430

    Article  PubMed  Google Scholar 

  6. Kao HL, Lin MS, Wang CS, Lin YH, Lin LC, Chao CL, Jeng JS, Yip PK, Chen SC (2007) Feasibility of endovascular recanalization for symptomatic cervical internal carotid artery occlusion. J Am Coll Cardiol 49(7):765–771

    Article  PubMed  Google Scholar 

  7. Masuo O, Terada T, Matsuda Y, Ogura M, Tsumoto T, Yamaga H, Itakura T (2006) Successful recanalization by in-stent percutaneous transluminal angioplasty with distal protection for acute carotid stent thrombosis. Neurol Med Chir Tokyo 46(10):495–499

    Article  PubMed  Google Scholar 

  8. Meyers PM, Higashida RT, Phatouros CC, Malek AM, Lempert TE, Dowd CF, Halbach VV (2000) Cerebral hyperperfusion syndrome after percutaneous transluminal stenting of the craniocervical arteries. Neurosurgery 47(2):335–343

    Article  PubMed  CAS  Google Scholar 

  9. Miyamoto N, Naito I, Takatama S, Shimizu T, Iwai T, Shimaguchi H (2008) Urgent stenting for patients with acute stroke due to atherosclerotic occlusive lesions of the cervical internal carotid artery. Neurol Med Chir Tokyo 48(2):49–55

    Article  PubMed  Google Scholar 

  10. Schlaug G, Benfield A, Baird AE, Siewert B, Lövblad KO, Parker RA, Edelman RR, Warach S (1999) The ischemic penumbra: operationally defined by diffusion and perfusion MRI. Neurology 53(7):1528–1537

    PubMed  CAS  Google Scholar 

  11. Shojima M, Nemoto S, Morita A, Miyata T, Namba K, Tanaka Y, Watanabe E (2010) Protected endovascular revascularization of subacute and chronic total occlusion of the internal carotid artery. AJNR Am J Neuroradiol 31(3):481–486

    Article  PubMed  CAS  Google Scholar 

  12. Srinivasan A, Goyal M, Stys P, Sharma M, Lum C (2006) Microcatheter navigation and thrombolysis in acute symptomatic cervical internal carotid occlusion. AJNR Am J Neuroradiol 27(4):774–779

    PubMed  CAS  Google Scholar 

  13. Sugg RM, Malkoff MD, Noser EA, Shaltoni HM, Weir R, Cacayorin ED, Grotta JC (2005) Endovascular recanalization of internal carotid artery occlusion in acute ischemic stroke. AJNR Am J Neuroradiol 26(10):2591–2594

    PubMed  Google Scholar 

  14. Terada T, Tsuura M, Matsumoto H, Masuo O, Tsumoto T, Yamaga H, Itakura T (2006) Endovascular treatment for pseudo-occlusion of the internal carotid artery. Neurosurgery 59(2):301–309

    Article  PubMed  Google Scholar 

  15. Terada T, Okada H, Nanto M, Shintani A, Yoshimura R, Kakishita K, Masuo O, Matsumoto H, Itakura T, Ohshima K, Yamaga H (2010) Endovascular recanalization of the completely occluded internal carotid artery using a flow reversal system at the subacute to chronic stage. J Neurosurg 112(3):563–571

    Article  PubMed  Google Scholar 

  16. Wang H, Lanzino G, Fraser K, Tracy P, Wang D (2003) Urgent endovascular treatment of acute symptomatic occlusion of the cervical internal carotid artery. J Neurosurg 99(6):972–977

    Article  PubMed  Google Scholar 

  17. Wintermark M, Reichhart M, Thiran JP, Maeder P, Chalaron M, Schnyder P, Bogousslavsky J, Meuli R (2002) Prognostic accuracy of cerebral blood flow measurement by perfusion computed tomography, at the time of emergency room admission, in acute stroke patients. Ann Neurol 51(4):417–432

    Article  PubMed  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kenichi Kono.

Additional information

Comment

The authors present their successful experience with revascularization of acute carotid artery occlusion using a flow reversal system in three cases. The manuscript is will written and describes in detail the cases throughout presentation, radiological findings, and the procedure, as well as the clinical and radiological results. There are few publications in the literature describing the recanalization of acute internal carotid artery occlusion. According to our experience, use of a flow-reversal system is a good application of procedural technique (especially in the setting of an acute occlusion with soft clot) that will eliminate the risk of distal emboli. The authors discuss the advantages and the disadvantages of this technique as well as the rationale behind the recanalization procedure in each case.

Shady Jahshan

L. Nelson Hopkins

Buffalo, New York, USA

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kono, K., Tanaka, Y., Yoshimura, R. et al. Emergent carotid artery stenting using a flow reversal system for acute atherosclerotic occlusion of the internal carotid artery. Acta Neurochir 153, 2175–2180 (2011). https://doi.org/10.1007/s00701-011-1142-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-011-1142-y

Keywords

Navigation